Are you losing it?

Midlife forgetfulness might just be a part of aging

By Katy HillenmeyerNYT Regional Newspapers

Published: Wednesday, January 4, 2006 at 4:30 a.m.

Last Modified: Wednesday, January 4, 2006 at 12:00 a.m.

Single mom Dee Dee Ford's brain circuitry is overloaded with details, from voicemail, computer and bank account passwords to where she stowed her ATM card, eyeglasses and car keys. Though friends marvel at the 48-year-old woman's recall of details from decades past, her short-term memory often lapses as she juggles a commute to work in Sonoma, Calif., her daughter's school and sporting events, and her own volunteer and social demands.

"I find myself just more scattered and forgetting things," said Ford, whose boyfriend has outfitted her with beaded eyeglass chains.

"I look ridiculous, but at least I know where my glasses are," she laughed. "I don't have to tear my car apart."

Ford falls into that 45- to 60-year-old range when, according to researchers, adults' busyness peaks -- about 20 years after their memory has begun to slip.

"The combination of aging and being extremely busy is a double whammy," said Denise Park, a University of Illinois psychologist who co-directs its Roybal Center for Healthy Minds. "We have a lot of data that shows middle-aged adults are less likely to take their medications correctly than older adults. Busy people, people who multitask, forget a lot of things."

As baby boomers approach their 60s, when the risk of dementia begins to increase with each decade, the question, "Is my memory loss normal?" pops up everywhere -- from mental health clinics to magazine covers.

Forgetting a name, movie title, grocery list item or freeway exit plagues many people in midlife and beyond, mental health experts agreed, as the brain's ability to retrieve information naturally slows. But unless memory failures interfere with caring for yourself and others, running a household, maintaining a job and driving a car, you likely are among those neurologist Allan Bernstein calls the "worried well."

Bernstein, a neurologist in Santa Rosa, Calif., compares age-related loss of brain cells and cognitive function to a computer that locks up.

"The hard drive just takes a little longer to reboot," he said. "We haven't lost it; there's just a little delay in retrieving it."

Speed of processing information and the ability to avoid distractions also begin to decline by our late 20s, said National Institute on Aging researcher Jeffrey Elias. So "we are all more prone to interference," and the word-association tricks once used to recall grocery lists or to-do's won't come to mind so spontaneously.

"By the 40s, the multitasking you used to love on your job when you were in your 20s and 30s is just getting to be a little too much," Elias said.

By our late 50s or 60s, brain atrophy or shrinkage can be detected on a brain scan, said Dr. Gary Small, a psychiatrist at University of California Los Angeles. "And when cells shrink," he said, "they don't function as well."

But without a loss of executive function -- the skills to sequence, organize, plan and monitor your own behavior -- failing memory would not signal dementia, Small and other experts agreed.

"Normal is being able to carry on your daily activities without impairment," said Bernstein.

At the University of Illinois, Park led a study of 350 adults, ranging in age from their 20s to 90s, tracking their memory losses across the lifespan. "The changes are subtle and small: They accrue over a period of many years," Park noted.

To distinguish between normal aging and Alzheimer's disease or other dementias, health professionals rely on family histories, brain scans, medical exams, lab work, cognitive testing and a comparison of current functioning versus prior functioning.

Slowing the decline

Advancing age and a genetic risk of dementia are irreversible. But many conditions that may impair the memory can be reversed or treated, including:

Vitamin deficiencies, including inadequate B12: One fifth of people 60 and older, and 40 percent of those over 80, lose some ability to absorb vitamin B12, Small noted in his book The Memory Prescription

n Stress, anxiety and depression: "The 40-year-old who thinks they have Alzheimer's is unlikely to have Alzheimer's, but they're very likely to have depression," Bernstein said. "The symptoms mimic each other."

Physical inactivity: Psychologist Arthur Kramer, Park's co-director at the Center for Healthy Minds in Illinois, tested the impact of walking 45 minutes three times weekly in sedentary older adults.

Kramer documented improvements in the walkers in memory, attention and their ability to multitask after six months on the aerobic regimen.

Aerobic fitness "increases the number of connections between neurons and increases blood supply" to the brain, Kramer said. "Some data suggests that new neurons can even be born in middle-aged and older brains, and exercise is one way to do that."

Memory 'Boot Camp'

At UCLA, Small promotes a 14-day memory "boot camp," combining mental stimulation, physical conditioning, a healthful diet and stress reduction. Michele Rubin, a 47-year-old former pharmacist from Beverly Hills, adopted the two-week regimen and improved one memory test score to the average typical of a 25-year-old, Small said.

Concerned about slowing recall and forgetfulness about things her family members had told her, the mother of three embraced Small's recommendations.

She began eating foods rich in antioxidants and fish containing omega-3 fatty acids, started a cardiovascular workout at her gym, afforded herself the luxury of nonfiction reading and jumped back into mentally taxing pursuits she'd avoided in her busy life, such as helping her kids with science and math homework.

At the University of Illinois, Park has tested how learning new skills -- quilting and digital photography -- influenced the cognitive function of volunteers aged 65 to 80 who previously were relatively inactive or stayed at home.

For eight to 10 weeks, the volunteers engaged in 15 hours each week of either the photography or quilting, and Park said the results from small, pilot studies showed promise. "It would suggest that staying engaged across the lifetime might genuinely improve your cognition," she said.

Park plans a much larger trial to test the effects of such stimuli.

"We know what to do to have a healthy heart," she said, "and we're starting to learn what to do to have a healthy mind."

<p>Single mom Dee Dee Ford's brain circuitry is overloaded with details, from voicemail, computer and bank account passwords to where she stowed her ATM card, eyeglasses and car keys. Though friends marvel at the 48-year-old woman's recall of details from decades past, her short-term memory often lapses as she juggles a commute to work in Sonoma, Calif., her daughter's school and sporting events, and her own volunteer and social demands.</p><!-- Nothing to do. The paragraph has already been output --><p>"I find myself just more scattered and forgetting things," said Ford, whose boyfriend has outfitted her with beaded eyeglass chains.</p><p>"I look ridiculous, but at least I know where my glasses are," she laughed. "I don't have to tear my car apart."</p><p>Ford falls into that 45- to 60-year-old range when, according to researchers, adults' busyness peaks -- about 20 years after their memory has begun to slip.</p><p>"The combination of aging and being extremely busy is a double whammy," said Denise Park, a University of Illinois psychologist who co-directs its Roybal Center for Healthy Minds. "We have a lot of data that shows middle-aged adults are less likely to take their medications correctly than older adults. Busy people, people who multitask, forget a lot of things."</p><p>As baby boomers approach their 60s, when the risk of dementia begins to increase with each decade, the question, "Is my memory loss normal?" pops up everywhere -- from mental health clinics to magazine covers.</p><p>Forgetting a name, movie title, grocery list item or freeway exit plagues many people in midlife and beyond, mental health experts agreed, as the brain's ability to retrieve information naturally slows. But unless memory failures interfere with caring for yourself and others, running a household, maintaining a job and driving a car, you likely are among those neurologist Allan Bernstein calls the "worried well."</p><p>Bernstein, a neurologist in Santa Rosa, Calif., compares age-related loss of brain cells and cognitive function to a computer that locks up.</p><p>"The hard drive just takes a little longer to reboot," he said. "We haven't lost it; there's just a little delay in retrieving it."</p><p>Speed of processing information and the ability to avoid distractions also begin to decline by our late 20s, said National Institute on Aging researcher Jeffrey Elias. So "we are all more prone to interference," and the word-association tricks once used to recall grocery lists or to-do's won't come to mind so spontaneously.</p><p>"By the 40s, the multitasking you used to love on your job when you were in your 20s and 30s is just getting to be a little too much," Elias said.</p><p>By our late 50s or 60s, brain atrophy or shrinkage can be detected on a brain scan, said Dr. Gary Small, a psychiatrist at University of California Los Angeles. "And when cells shrink," he said, "they don't function as well."</p><p>But without a loss of executive function -- the skills to sequence, organize, plan and monitor your own behavior -- failing memory would not signal dementia, Small and other experts agreed.</p><p>"Normal is being able to carry on your daily activities without impairment," said Bernstein.</p><p>At the University of Illinois, Park led a study of 350 adults, ranging in age from their 20s to 90s, tracking their memory losses across the lifespan. "The changes are subtle and small: They accrue over a period of many years," Park noted.</p><p>To distinguish between normal aging and Alzheimer's disease or other dementias, health professionals rely on family histories, brain scans, medical exams, lab work, cognitive testing and a comparison of current functioning versus prior functioning.</p><p>Slowing the decline</p><p>Advancing age and a genetic risk of dementia are irreversible. But many conditions that may impair the memory can be reversed or treated, including:<li>High-fat diets lacking fruits, vegetables, whole grains, adequate protein and other nutrients.<li>Vitamin deficiencies, including inadequate B12: One fifth of people 60 and older, and 40 percent of those over 80, lose some ability to absorb vitamin B12, Small noted in his book The Memory Prescription</p><p>n Stress, anxiety and depression: "The 40-year-old who thinks they have Alzheimer's is unlikely to have Alzheimer's, but they're very likely to have depression," Bernstein said. "The symptoms mimic each other."<li>Physical inactivity: Psychologist Arthur Kramer, Park's co-director at the Center for Healthy Minds in Illinois, tested the impact of walking 45 minutes three times weekly in sedentary older adults.</p><p>Kramer documented improvements in the walkers in memory, attention and their ability to multitask after six months on the aerobic regimen.<li>Aerobic fitness "increases the number of connections between neurons and increases blood supply" to the brain, Kramer said. "Some data suggests that new neurons can even be born in middle-aged and older brains, and exercise is one way to do that."</p><p>Memory 'Boot Camp'</p><p>At UCLA, Small promotes a 14-day memory "boot camp," combining mental stimulation, physical conditioning, a healthful diet and stress reduction. Michele Rubin, a 47-year-old former pharmacist from Beverly Hills, adopted the two-week regimen and improved one memory test score to the average typical of a 25-year-old, Small said.</p><p>Concerned about slowing recall and forgetfulness about things her family members had told her, the mother of three embraced Small's recommendations.</p><p>She began eating foods rich in antioxidants and fish containing omega-3 fatty acids, started a cardiovascular workout at her gym, afforded herself the luxury of nonfiction reading and jumped back into mentally taxing pursuits she'd avoided in her busy life, such as helping her kids with science and math homework.</p><p>"Just defining what normal, age-related memory loss is was really helpful for me," Rubin recalled, "so I didn't feel like, 'Oh, my God, I'm having early signs (of dementia).' Everybody has these symptoms."</p><p>At the University of Illinois, Park has tested how learning new skills -- quilting and digital photography -- influenced the cognitive function of volunteers aged 65 to 80 who previously were relatively inactive or stayed at home.</p><p>For eight to 10 weeks, the volunteers engaged in 15 hours each week of either the photography or quilting, and Park said the results from small, pilot studies showed promise. "It would suggest that staying engaged across the lifetime might genuinely improve your cognition," she said.</p><p>Park plans a much larger trial to test the effects of such stimuli.</p><p>"We know what to do to have a healthy heart," she said, "and we're starting to learn what to do to have a healthy mind."</p><p>Katy Hillenmeyer writes for The Press Democrat in Santa Rosa, Calif.</p>